Patient distress and its negative impact on treatment continuation: do psychological interventions have a significant impact?

Recent studies have shown a high prevalence of psychological distress among fertility patients and how it correlates with decreases in IVF treatment continuation rates. In addition, research has demonstrated the efficacy of psychological interventions, especially cognitive behavioral therapy and mind-body interventions, in reducing fertility patient distress and potentially increasing pregnancy rates. With the significant relationships between patient distress and dropout rates and between psychological interventions and decreased patient distress both established, the question that remains unaddressed is the impact of psychological interventions on IVF discontinuation rates. Specifically, if it is known that infertility patients are distressed, that the distress is associated with treatment termination, and that psychological interventions can lead to significant decreases in distress, can and do these interventions also increase treatment continuation rates? This mini-review examines the prevalence of negative psychological symptoms in individuals with infertility, why patients discontinue fertility treatment, the efficacy of psychological interventions on patient distress, and, ultimately, the efficacy of psychological interventions on fertility patient retention.